Acute Pain Service for Postoperative Pain in Adults: a network meta-analysis.

IF 12.5 2区医学 Q1 SURGERY

International journal of surgery Pub Date : 2025-04-22 DOI:10.1097/JS9.0000000000002419

Lu Chen, Xixia Feng, Ling Ye, Jiaqi Yang, Ruihao Zhou, Yong Qiu, Guo Chen, Tao Zhu

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引用次数: 0

Abstract

Background: Postoperative pain significantly impacts patients' quality of life and recovery. Although acute pain services (APS) have been implemented in many hospitals worldwide, no study has directly compared the efficacy of different APS subtypes in managing acute postoperative pain.

Objective: This network meta-analysis aimed to evaluate the effectiveness of various APS models in alleviating postoperative pain in adults undergoing surgery.

Methods: Four English-language databases (PubMed, Web of Science, Embase, and Cochrane Library) and three Chinese-language databases (CNKI, WANFANG, and SinoMed) were searched to identify randomized controlled trials (RCTs) that compared the efficacy of different pain management models for postoperative pain in adult patients. Statistical analyses were conducted using R version 4.4.2 and Stata version 18.

Results: A total of 38 studies were included in this network meta-analysis. All APS subtypes demonstrated superior pain relief compared to the traditional ward doctor-nurse model. These included nurse-based anesthesiologist specialist-supervised APS (NBASS-APS; SMD: - 1.99, 99%CI: - 2.55, - 1.43), nurse-based anesthesiologist-supervised APS (NBAS-APS; SMD: - 1.44, 99%CI: - 2.18, - 0.70), pain management multidisciplinary team (PMDT; SMD: - 1.31, 99%CI: - 1.74, - 0.87), and conventional APS (C-APS; SMD: - 0.83, 99%CI: - 1.43, - 0.24). Surface under the cumulative ranking (SUCRA) analysis identified NBASS-APS as having the highest probability of achieving optimal pain relief (98.0%), followed by NBAS-APS (65.9%), PMDT (58.0%), C-APS (28.1%), and the traditional model (0.1%).

Conclusion: APS models are significantly more effective than the traditional ward doctor-nurse model in relieving postoperative pain, with NBASS-APS emerging as the most promising approach, followed by NBAS-APS, PMDT, and C-APS.

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急性疼痛服务对成人术后疼痛：网络荟萃分析。

背景：术后疼痛显著影响患者的生活质量和康复。虽然急性疼痛服务（APS）已在全球许多医院实施，但没有研究直接比较不同APS亚型在处理急性术后疼痛方面的疗效。目的：本网络荟萃分析旨在评估各种APS模型在减轻成人手术术后疼痛方面的有效性。方法：检索四个英文数据库（PubMed、Web of Science、Embase和Cochrane Library）和三个中文数据库（CNKI、WANFANG和SinoMed），以确定比较不同疼痛管理模式对成年患者术后疼痛疗效的随机对照试验（RCTs）。采用R 4.4.2版本和Stata 18版本进行统计分析。结果：该网络荟萃分析共纳入38项研究。与传统的病房医生-护士模式相比，所有APS亚型均表现出优越的疼痛缓解效果。这些包括以护士为基础的麻醉师、专家监督的APS (nbas -APS)；SMD: - 1.99, 99%CI: - 2.55, - 1.43)，护士麻醉师监督APS (NBAS-APS；SMD: - 1.44, 99%CI: - 2.18, - 0.70)，疼痛管理多学科团队(PMDT；SMD: - 1.31, 99% ci: 1.74 - 0.87),和传统的APS (C-APS;Smd: - 0.83, 99%ci: - 1.43, - 0.24)。根据累积排名（SUCRA）分析，NBAS-APS达到最佳疼痛缓解的概率最高（98.0%），其次是NBAS-APS（65.9%）、PMDT（58.0%）、C-APS（28.1%）和传统模型（0.1%）。结论：APS模式在缓解术后疼痛方面明显优于传统病房医护模式，其中NBAS-APS是最有希望的模式，其次是NBAS-APS、PMDT和C-APS。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of surgery SURGERY-

CiteScore

17.70

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： The International Journal of Surgery (IJS) has a broad scope, encompassing all surgical specialties. Its primary objective is to facilitate the exchange of crucial ideas and lines of thought between and across these specialties.By doing so, the journal aims to counter the growing trend of increasing sub-specialization, which can result in "tunnel-vision" and the isolation of significant surgical advancements within specific specialties.